Recent advances of fundamentals and clinical researches of cholemic nephropathy

Abstract

Cholemic nephropathy （CN） is a disease with renal dysfunction as a major manifestation in patients with advanced chronic liver disease complicated with severe jaundice. Currently no effective non-invasive diagnostic modality is available for CN. Renal biopsy has been a gold standard for its clinical diagnosis. Furthermore, it is frequently misdiagnosed or confused with hepatorenal syndrome so that patient prognosis remains poor. The overall objective of clinical management is lowering a high level of bilirubin and blunting renal injury. If drug therapy fails, artificial liver systems may be employed for improving renal function. The underlying pathological mechanisms of CN have not been fully elucidated. However, recent studies implied that the development of disease was correlated closely with abnormal renal transporters, oxidative stress and inflammatory responses. Based upon previous studies, the authors summarized the latest researches on CN through focusing upon clinical diagnosis, potential pathogenesis and therapeutic strategies for providing theoretical rationales for advanced researches and clinical interventions of CN.

Keywords

• cholemic nephropathy
• bile cast
• advanced liver disease
• jaundice
• acute renal dysfunction